Tips for Working with Older Adults Who Hoard
Hoarding is a growing mental health problem among older adults in the United States. In fact, an estimated 1.5 to 3 million Americans are thought to struggle with hoarding. Although studies show hoarding behavior is common in adolescence, severity amplifies as a person ages and is most prevalent among older adults. Since many seniors receive health and social services at home on a regular basis, members of home care staff, visiting nurses, and social workers are well positioned to spot signs of hoarding and initiate needed intervention. But as our aging population increases, so will the number of older adults whom hoarding is a problem. Are we prepared with trained healthcare professionals to meet demand? Treating an older adult who hoards requires sensitivity and proper training. The failure to disregard possessions can result in cluttered living that precludes functional living, causing significant stress and impairment for the person. Elderly hoarders may faces problems with pending eviction, problems with neighbors, and rejection by family. Professionals must be skilled in assessing a number of variables affecting the hoarding condition including, the senior’s mental and physical capacities (frailty and dementia, for example), family involvement, and finances. Experts also recognize that hoarders often share personality characteristics: indecisiveness, a tendency to procrastinate or avoidance, and perfectionism. Being able to identify dementia is important as well. Hoarding can be a symptom of dementia. According to the Alzheimer’s Association, 20% of those with dementia suffer with hoarding problems. Hoarding behaviors are also seen in those suffering with OCD, depression, schizophrenia, or brain injury. When working with older adults who hoard, it is essential to make client safety a main priority. A hoarder’s home, at minimum, needs to feature a working toileting and separate sink area, clear walking paths in rooms, no infestations of rodents or insects, no excessive accumulation of garbage, access to emergency escapes (doors, fire escapes) and working electrical outlets. The Geriatric Mental Health Alliance of New York suggests the following tips for professionals working with older adults who hoard:
- Let go of your personal “ideal” notions of cleanliness.
- Start by asking the person what they would like to do that they currently cannot.
- Begin by reorganizing. Create a minimum category for sorting such as: Keep, Throw Away, Donate.
- Listen to the senior’s stories about items as well as his or her plan for the belongings
- Focus on fall prevention. Create clear pathways that are free of debris, loose cords, or slippery rugs.
- Enforce fire protection measures. Install smoke alarms and look for newspapers or magazines near stoves or radiators.
- Protect the senior’s privacy. Shred paper documents with personal information. Never leave trash bags on the property after cleanup, even overnight.
- Create a plan for on-going maintenance and “checking in” to ensure the space stays de-cluttered.